Healthy Roads: A Community-Driven Approach to Mental Wellness 

Our program, The Family Van, a mobile clinic in Boston, has long been committed to providing culturally and linguistically responsive healthcare to the city’s vibrant and multicultural neighborhoods of Roxbury, Dorchester, and East Boston. These areas, rich in cultural heritage and diversity, face distinct challenges around mental health. In January 2021, we introduced a mental health initiative, Healthy Roads, to address the unique needs of these neighborhoods. In this blog, we delve into how The Family Van’s team is making a significant impact on mental health in these communities, fostering resilience and promoting head to toe well-being. 
 
Meet The Family Van Team Interviewed:  Rainelle Walker-White, Associate Director of Health Equity Programs; Dina Martinez, a dedicated Community Health Worker; and Piper Derenoncourt, Associate Director of Mental Health Equity Programs. Their combined expertise and deep connections to the community are central to the success of Healthy Roads. 

Q: How did you identify the mental health needs in the community? 

Rainelle Walker-White: Our mobile clinic, The Family Van, has been a trusted source of health information in the communities of Boston since 1992. Our team of Community Health Workers (CHWs) have deep connections within the neighborhoods we serve and speak the same languages as our clients, which helps our clients feel comfortable discussing their struggles. 
 
Through our daily interactions, we saw the need for accessible, affordable mental health support that respects cultural and linguistic differences. One of our most important roles at our mobile clinic is to offer a listening ear. Every day we listen to our clients talk about their stresses and challenges, such as community violence and domestic abuse, issues around immigration, like separation from their families and social isolation. We also pay close attention to the challenges faced by people with disabilities, which can be eye-opening. There are many visually impaired individuals, people who are hard of hearing, those who use prosthetics, and individuals in wheelchairs. These conditions can bring a lot of stress and anxiety to their daily lives. 

 
Q: Please provide an overview of Healthy Roads and explain how it supports individuals in the community?  

Rainelle Walker-White: Healthy Roads helps our clients deal with different life challenges like anxiety, depression, family issues, financial problems, and housing – all of which can greatly affect your mental health.  We provide practical tools and resources to help clients overcome obstacles and see themselves moving past these challenges. We teach coping, problem-solving, and help-seeking skills to improve both mental and physical health.   

Piper Derenoncourt: What sets Healthy Roads apart is its foundation in community-led design by CHWs who understand the lived experiences of those we serve. The program aims to reduce stigma surrounding mental health care and improve access to culturally and linguistically responsive support. Unlike many mental health programs rooted in white-dominant culture and norms, Healthy Roads offers client-led sessions guided by trained CHWs, who have deep insights into community resources. The program is free of charge and consists of five sessions tailored to the client’s pace, available in English, Spanish, and Portuguese via telehealth or in-person at our mobile clinic. 

“We developed Healthy Roads by listening to the experiences of people of color
in Boston and using best practices from experts in the field.”

– Rainelle Walker-White, Associate Director of Health Equity Programs

 
Q: Tell us about the development process of Healthy Roads? 
 
Rainelle Walker-White:  We developed Healthy Roads by listening to the experiences of people of color in Boston and using best practices from experts in the field. 
 
To truly serve a community, you need to listen to its members rather than assuming their needs. To start, we formed a task force, which included CHWs, volunteers, and students. We held multiple community listening sessions to identify the unique barriers people face in accessing support and found ways for The Family Van to bridge these gaps. This approach allowed us to build a foundation rooted in community feedback. 
 
Piper Derenoncourt:  We selected the World Health Organization’s Problem Management Plus (PM+) curriculum, an evidence-based, globally recognized framework for providing low-intensity psychological interventions. PM+ supports adults experiencing acute and chronic distress, especially in high-adversity communities. It uses basic techniques from Cognitive Behavioral Therapy and Interpersonal Therapy, making it accessible for non-mental health specialists with proper training and supervision. 
 
We adapted PM+ to fit the unique cultural, social, and historical aspects of our communities. This involved customizing our marketing, screening, and enrollment processes, and definitions of success.  For example, initially, we used standard clinical screening tools like the Patient Health Questionnaire 9 (PHQ-9) and General Anxiety Disorder 7 (GAD-7). However, we found that these tools did not accurately capture the distress clients described when discussing their life stressors. Clients either did not understand the questions and response options or answered differently due to fear of being diagnosed and stigma.  In response, we transitioned to a more conversational, relationship-centered screening process to discuss the impacts of stress in their lives. This change was crucial given the high levels of stigma, distrust, and historical trauma associated with traditional “mental health” systems in our communities.  

Q: How did you address the stigma associated with mental health in the communities you serve, and what additional challenges have you encountered? 

Rainelle Walker-White: When we first started implementing Healthy Roads, our Haitian community had a strong stigma against mental health. This community is known for its resilience and strong faith, often handling challenges on their own. By framing Healthy Roads as a support system rather than a mental health program, we were able to open the door and offer practical help.  We intentionally refer to the program as a “wellness response program” or “head-to-toe wellness” instead of a “mental health program.” 

Dina Martinez: Our approach with Healthy Roads is designed to be inviting and non-judgmental. We avoid terms like “depression” or “anxiety”, so the client never feels labeled. It’s about making them feel comfortable. In my two and a half years, I’ve never faced anyone rejecting our help. Listening skills are crucial, and once people trust you, they’re more willing to work with you. 

Healthy Roads also addresses interconnected problems. For example, in the Hispanic community, issues related to immigration and leaving family behind can greatly affect mental health. We often see that anxiety and depression go hand-in-hand with food and nutrition problems. Many people eat emotionally because of stress from leaving their family behind. Helping someone with their relationship with food can improve their mood and overall well-being. We’ve seen amazing changes in our clients’ lives. We see how food, nourishment, and subsequent weight loss can help release some trauma and pain, improving emotional and mental wellness. 

“Our approach with Healthy Roads is designed to be inviting and non-judgmental. We avoid terms like “depression” or “anxiety”, so the client never feels labeled. It’s about making them feel comfortable.”

– Dina Martinez, a dedicated Community Health Worker at the family van

 
Q. Can you share any success stories from individuals who have participated in Healthy Roads? 

Dina Martinez:  We have many examples! Men are typically more resistant to try the program because of strong cultural beliefs in the communities we serve. For instance, one of our regular clients initially said, “Dina, yo no estoy loco.” (Dina, I’m not crazy.) My approach really makes a difference. I encourage clients to open up by simply asking, “Are you willing to just tell me about your day?” I’m here to offer a listening ear. 

One of my favorite stories is about a client who was struggling with severe sleep issues because he lived on a busy main road with constant traffic noise.* It was so bad that he couldn’t get any rest and, as a result, he had no energy. This client drives buses during the day, and he had to stop walking, a hobby he loved, because he was too exhausted. 

He told me, “I’ve tried everything, even sleepy teas, but nothing works because the noise never stops.” Moving wasn’t an option, so we brainstormed a list of possible solutions together and we landed on the idea of trying earplugs. Initially he said, “Dina, they hurt and fall out.” I knew what he meant because I’ve used earplugs myself. I encouraged him to keep trying and see how it goes. 

In the second week, he was still struggling with the discomfort but was willing to keep trying. We took a step back, and I showed him how to insert the earplugs. Slowing down and demonstrating how to fit them made all the difference. He soon shared how he started sleeping better—first four hours, then six, and eventually eight hours. 

The client came back to me and said, “Dina, I went for a walk today because I slept so well last night.” He returned to the version of himself that he was missing. By restoring his sleep patterns, he was able to get back to his hobby of walking, increase his physical activity and felt much more alert and awake for his job driving buses. It was a huge step in safety and well-being for him. 

And all of this came from something as simple as earplugs. It’s a reminder of how we can support clients by slowing down and identifying small changes that can make a big difference. 

Q: What kind of training and support do community health workers receive? 

Rainelle Walker-White: In 2020, Partners in Health provided guidance on how to approach adapting PM+ to our setting. They also led our initial PM+ training over six weeks, which included recorded videos, group discussion and role plays.  They adapted their in-person training to Zoom due to the COVID pandemic. Since this, we have trained two additional staff ourselves and have trained volunteers, interns and medical students on how to talk about the program and screen for mental health distress. 

Piper Derenoncourt: We are fortunate to have an organizational culture that supports ongoing learning and growth alongside staff wellness. Our CHWs have access to regular supervision and peer support. Staff can access a wide variety of continuing education opportunities through our Harvard University network and in the Boston area. While there are some trainings we have everyone attend, we work with everyone to support their individual learning goals. We also host regular staff wellness workshops and social outings. We strongly encourage staff to use their employee benefits to support their well-being. We know it takes a lot to truly listen and be present with clients facing complex life challenges from migration trauma to racism and that each provider needs to have support to step away and take care of their own well-being. 

Q: How adaptable is the program to different expertise and community needs? 

Rainelle Walker-White: Each one of our Community Health Workers implements the program differently based on their strengths and skills, but we all follow the same basic core skills which we learned in the training. For example, Dina brought a unique perspective around nutrition and wellness. Her expertise helped us see how important nutrition, sleep, and physical activity are for overall wellness.  

Piper Derenoncourt: In 2023, The BlueCross Blue Shield Foundation of MA invited us to be a technical assistance partner alongside Partners in Health and the Institute for Community Health to expand access to PM+ throughout Massachusetts. This initiative, Advancing Community Driven Mental Health, really highlights how adaptable PM+ is. We selected five community-based organizations with unique populations and non-medical lay providers to adapt, train staff and offer PM+ in their community settings. We have seen how impactful a program like this can be by equipping providers in community settings with knowledge, tools, and resources to support clients experiencing mental health distress. As Rainelle mentioned, the core skills of each session stay the same, but the approach might look slightly different depending on the unique gifts of the provider, the language/culture of the client and the setting they are in. 

Q. How does the program measure its impact? How do you know it’s working?  

Piper Derenoncourt: That’s a great question! We have a comprehensive approach to measuring the impact of our program. We started by developing a logic model and designing a mixed-methods evaluation plan. This plan helps us identify key metrics that allow us to understand both the implementation and overall impact of the program. 

To achieve this, we developed key questions to assess whether the program is effectively reaching its target audience and how participants perceive its quality. To understand the overall impact, we focused on three domains: 

1. Knowledge and Skills: Are participants gaining new knowledge or skills specific to Healthy Roads? 
2. Help-Seeking Behavior: Are they more inclined to seek help when needed? 
3. Mental Well-Being: Are participants experiencing improved mental well-being or better coping with life stressors? 

To gather this information, we collect both quantitative and qualitative data during different stages of the program, including screening, enrollment, intake, and PM+ sessions. By regularly monitoring this data, we can identify trends, needs, and opportunities for improvement.  

We’ve had to thoughtfully ask ourselves what does success look like? While five sessions can significantly reduce someone’s distress, even one session can be beneficial if it connects the participant to long-term support, helps them find a new job, or reconnects them with family. In behavioral health, every individual’s journey to wellness is unique and constantly evolving. Therefore, we need to look beyond numbers and understand the context and stories behind each data point. 

Rainelle Walker-White: We also conduct follow-up calls within a month or two of completing the sessions to hear directly from participants. We ask them how the program has benefited them, what challenges they faced, and what changes they’ve noticed. These calls are conducted by a staff member who didn’t work directly with the participant to avoid bias and ensure confidentiality. This feedback is invaluable in helping us understand the real-world impact of our program and make necessary adjustments. 

Q: What steps would you recommend for another mobile clinic interested in starting a similar program? And are there any challenges organizations should be aware of when implementing this program in their community? 

Rainelle Walker-White: Success depends on adaptability and the dedication of community health workers. It’s crucial to have a team that can connect with clients and provide the necessary resources. Basic training, robust support systems, and self-care are essential for community health workers, as they often bear a lot of emotional weight from their clients. 

Dina Martinez: One challenge is finding mental health providers who are people of color or speak the client’s language. The shortage of mental health professionals and high caseloads make this difficult. We strive to connect clients with suitable providers, but it’s not always easy. 

Another challenge is that not all clients are ready to commit to the program initially. They may start with enthusiasm but face other barriers that prevent them from continuing. It’s important to remain persistent and keep reaching out, as clients may be ready to engage at a later time. 

Despite these challenges, many clients are enthusiastic and recommend our program to others. One client even said, “I wish you were my therapist because my therapist doesn’t understand my issues like you do.” This feedback highlights how our unique techniques and personalized approach set us apart.

* Some of the details of our client story shared above has been changed to preserve their privacy.